DIANE C JENSEN
Medical Practice at Gateside Ln, Marietta, GA

License number
Florida 103953
Issued Date
Mar 11, 2009
Effective Date
Feb 1, 2017
Expiration Date
Jan 31, 2017
Category
Health Care
Type
Medical Doctor
Address
Address
4630 Gateside Ln, Marietta, GA 30067
Phone
(770) 984-0949

Personal information

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Name
Address
Phone
Diane Jensen
41 Osborne Rd SE, Marietta, GA 30008
(770) 329-1985
Diane Jensen, age 59
3925 Loblolly Trl, Augusta, GA 30907
(706) 364-3646

Organization information

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DIANE C. JENSEN, M.D., PC

4630 Gateside Ln, Marietta, GA 30067

Industry:
Medical Doctor's Office
Registration:
Nov 25, 2003
State ID:
0364937
Business type:
Domestic Professional Corporation
Secretary, Medical Doctor:
Diane Jensen (Secretary, Medical Doctor), 4630 Gateside Ln, Marietta, GA 30067 (Physical)
Agent:
Chris Jensen,1447 Peachtree St SUITE 1009, Atlanta, GA (Physical)